Centre for Occupational and Environmental Health, The University of Manchester, Oxford Road, Manchester M13 9PL, UK.
Occup Environ Med. 2012 Dec;69(12):925-31. doi: 10.1136/oemed-2012-100754. Epub 2012 Oct 19.
Concerns over occupational exposures to blood-borne viruses resulted in increased protective glove use; consequentially latex allergy became a hazard for some occupational groups. Interventions aimed at managing this problem included substitution measures (eg, non-powdered/non-latex gloves), but such changes may not occur simultaneously across occupational sectors. This study evaluated whether the incidence of occupational dermatoses fell after interventions aiming to reduce exposure to 'latex and rubber glove allergens' ('latex') were introduced, and whether these interventions were more effective for healthcare workers (HCWs), compared with non-HCWs.
Incidence rate ratios (IRRs) comparing cases reported to EPIDERM (a UK-wide surveillance scheme) during post versus pre-intervention periods were calculated, both where 'latex' was cited and for cases associated with other exposures ('controls').
Among HCWs, cases of contact urticaria and allergic contact dermatitis (ACD) where 'latex' was cited showed significant downward trends post-intervention, with IRRs of 0.72, 95% CI; 0.52 to 1.00 and 0.47, 95% CI; 0.35 to 0.64 respectively. For HCWs, this fall in 'latex' associated ACD was significantly greater (p=0.02) than for other exposures ('controls') IRR=0.85, 95% CI; 0.57 to 1.28, and greater than that among non-HCWs (IRR 0.75, 95% CI; 0.61 to 0.93). Increases over time were seen for irritant contact dermatitis (ICD) reporting for HCWs, both for cases associated with 'latex' (IRR 1.47, 95% CI: 1.02 to 2.13) and for other exposures ('controls') IRR 1.36, 95% CI 1.06 to 1.76, but not for non-HCWs.
A reduction in overall ACD, particularly in HCWs, coincided with interventions aimed at managing workplace contact dermatoses associated with 'latex' exposure. A coincidental rise in ICD reporting is also important, both for hand care and for infection control strategies.
由于对职业性血液传播病毒暴露的担忧，人们增加了防护手套的使用；由此导致乳胶过敏成为某些职业群体的危害因素。旨在解决这一问题的干预措施包括替代措施（例如，无粉末/无乳胶手套），但此类变化可能不会同时在各职业部门发生。本研究评估了旨在减少“乳胶和橡胶手套变应原”（“乳胶”）暴露的干预措施实施后，职业性皮肤病的发病率是否下降，以及这些干预措施对医护人员（HCWs）是否比对非医护人员（非 HCWs）更有效。
通过计算 EPIDERM（英国范围内的监测计划）报告病例在干预前后期间的发病率比值（IRR），比较病例中引用的“乳胶”和与其他暴露（“对照”）相关的病例。
在 HCWs 中，与引用“乳胶”相关的接触性荨麻疹和过敏性接触性皮炎（ACD）病例在干预后呈明显下降趋势，IRR 分别为 0.72，95%CI；0.52 至 1.00 和 0.47，95%CI；0.35 至 0.64。对于 HCWs，与“乳胶”相关的 ACD 的这种下降幅度明显大于其他暴露（“对照”）IRR=0.85，95%CI；0.57 至 1.28，并且大于非 HCWs（IRR 0.75，95%CI；0.61 至 0.93）。HCWs 的刺激性接触性皮炎（ICD）报告随时间呈上升趋势，与引用“乳胶”相关的病例（IRR 1.47，95%CI：1.02 至 2.13）和与其他暴露（“对照”）IRR 1.36，95%CI 1.06 至 1.76 均如此，但非 HCWs 则不然。
与管理与“乳胶”暴露相关的工作场所接触性皮炎相关的干预措施的实施，导致 ACD 总体减少，尤其是在 HCWs 中。同时报告 ICD 的上升也很重要，这既与手部护理有关，也与感染控制策略有关。
